Researchers have reported that an Australian man who was HIV positive appears to have shed the virus without medical intervention.
The extremely rare case, involves a patient who appears to have spontaneously cleared his own HIV infection without any medication, many years after he was first infected.
However “Subject C135” appears to have a unique combination of fortunate circumstances that only serve to show how difficult it is to eliminate HIV infection once it is established.
The researchers warn that we do not yet know if the same characteristics could be re-created in other people with HIV by artificial means such as genetic engineering and vaccines.
The patient was infected with HIV in 1981 through a blood transfusion. Researchers have identified that all of the people who were infected from a donor who had HIV have unique symptoms.
Eight people were infected via the same donor, all of them are asymptomatic, while remaining HIV positive their CD4 counts remain stable without any medication.
Since they were first identified in the 1990’s several of the group have passed away, and six remain alive. The donor started antiretroviral therapy in 1999 after a CD4 count decline and the appearance of neurocognitive symptoms, and three of the infected patients have also started treatment in the intervening years.
Three of those in the cohort however still have non-progressing symptoms decades after they were first diagnosed, and they referred to as ‘elite controllers’.
A 2011 a study of the remaining three elite controllers found that the factor that most distinguished them from other cohort members was a strong CD4-cell response to the p24 capsid protein of HIV. In that paper it was noted that “only one patient, C135, has identifiable genetic polymorphisms that probably contributed to non-progression”. He was described as “unique” even then.
Now researchers are comfortable declaring that the man, now in his early 70’s is free of HIV. They have not been able to detect HIV in his system since 1997.
The last time detectable HIV DNA could be recovered from this patient was 22 years ago. Since then all attempts to find HIV have failed, so he could have in fact been clear of HIV by 1997.
Doctors have previously been hesitant to declare him free of the virus because there have been other cases where people have appeared to have beaten the virus, only for it to reappear years later.
A series of lucky factors appear to be the reason behind the man not developing any symptoms over the last 38 years. The HIV virus that he was infected with appears to be missing a strand of DNA, making it less effective, and he also had a series of genetic factors that made him more resistant to the virus taking hold.
It is unlikely that scientists could replicate the complex factors that occured and develop a cure for the virus, but it is giving researchers a greater understanding of how the virus can be slowed down and how different people react.
Read more details at AIDS Map.
OIP Staff
